Aims: To explore the association between maternal origin and birthplace, and caesarean section (CS) by pre-pregnancy body mass index (BMI) and length of residence. Methods: We linked records from 118,459 primiparous women in the Medical Birth Registry of Norway between 2013 and 2017 with data from the National Population Register. We categorized pre-pregnancy BMI (kg/m2) into underweight (<18.5), normal weight (18.5–24.9) and overweight/obese (≥25). Multinomial regression analysis estimated crude and adjusted relative risk ratios (RRR) with 95% confidence intervals (CI) for emergency and elective CS. Results: Compared to normal weight women from Norway, women from Sub-Saharan Africa and Southeast Asia/Pacific had a decreased risk of elective CS (aRRR = 0.57, 95% CI 0.37–0.87 and aRRR = 0.56, 0.41–0.77, respectively). Overweight/obese women from Europe/Central Asia had the highest risk of elective CS (aRRR = 1.42, 1.09–1.86). Both normal weight and overweight/obese Sub-Saharan African women had the highest risks of emergency CS (aRRR = 2.61, 2.28-2.99; 2.18, 1.81-2.63, respectively). Compared to women from high-income countries, the risk of elective CS was increasing with a longer length of residence among European/Central Asian women. Newly arrived migrants from Sub-Saharan Africa had the highest risk of emergency CS. Conclusion: Women from Sub-Saharan Africa had more than two times the risk of emergency CS compared to women originating from Norway, regardless of pre-pregnancy BMI.
Aim: The objectives of this study were to explore pregnant women's awareness of antenatal danger signs and birth preparedness as well as to identify associated factors in rural Gambia. Methods: A clinic-based cross-sectional study design was conducted at seven public health centres in rural Gambia involving a convenience sample of 145 pregnant women attending antenatal care services. Results: The study revealed that 61% of the pregnant women interviewed were aware of antenatal danger signs. In step wise multiple linear analyses, awareness of antenatal danger signs was significantly predicted by age, marital status and being advised on danger signs during antenatal visits. However, birth preparedness was low (14%) and multivariate logistic analyses showed that preparation was higher among literate women (OR= 5.12), employed women (OR=6.17), women with four or more antenatal visits (OR=4.62) and women with high awareness scores (OR=1.31). Conclusion: This study revealed a high level of awareness of antenatal danger signs despite deficiencies in the knowledge of some life threatening ones. However, the level of birth preparedness was low in the rural population studied. There is need to intensify efforts to provide health education on awareness of danger signs as well as to encourage birth preparation among pregnant women.
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